- MetroPlusHealth (New York, NY)
- …This position will work with our application vendors as well as Claims Operations , Utilization Management, Network Management, and other operational areas ... with business areas, vendor, governmental and partner organizations Work with claims editing vendors, Claims Operations , Utilization Management,… more
- ACSC Management Services Inc (Providence, RI)
- …Bachelors Equivalent combination of education and experience Preferred 7-9 years Claims handling and/or operations . Required 4-6 years Management/Supervisory ... Casualty Claims Unit Manager - Litigation This role will...position is typically responsible for managing four to ten Claims Teams, or it can manage specialized functions within… more
- Wake County Public School System (Cary, NC)
- Overview: POSITION TITLE (Oracle title) CHIEF FACILITIES AND OPERATIONS OFFICER WORKING TITLE Chief Facilities and Operations Officer SCHOOL/DEPARTMENT ... Provides leadership to the Facilities Design and Construction, Maintenance and Operations , Child Nutrition Services (CNS), and Transportation Departments. Leads and… more
- Sentry Insurance (Goldsboro, NC)
- …of conditional demand requirements across multiple states; knowledge of claims handling operations Strong analytical, communication, presentation, and ... As a Claims Legal Specialist - Conditional Demands, you'll act...and enterprise. Remain abreast of changes in law impacting operations as related to conditional demands across all fifty… more
- Jobleads-US (Calabasas, CA)
- …to perform at their best.**Essential Job Functions and Responsibilities Oversees Claims department operations , optimizing workflows and ensuring high ... Claims Manager-Workers Compensation page is loaded## Claims...you succeed. With over 35 specialty property and casualty operations , there are always opportunities here to learn and… more
- Carrot (Des Moines, IA)
- …troubleshoot and resolve issues An innovative spirit to push the boundaries of claims operations Preferred Qualifications: Literacy in Spanish (to support the ... Bachelors Degree 1-3 years of relevant work experience including claims submission/processing experience Highly detail-oriented and organized Structured thinker and… more
- Jobleads-US (Saddle Brook, NJ)
- …post-injury care. Participate in CCIP kickoff meetings and jobsite walkthroughs, attend Claims , Safety and Operations meetings to monitor current and anticipated ... Classification: Experienced Education: Bachelors Degree Job Family: Insurance and Claims Compensation: Salaried Exempt Position Description: Oversee insurance carriers… more
- Jobleads-US (Roseville, CA)
- …communicates frequently in a clear, concise manner Able to understand and articulate claims operations in a way that drives and achieves team(s) results ... CARE through our values, Sustainability initiatives and inclusive corporate culture. Our Claims team is currently seeking a Workers Compensation Unit Manager to join… more
- MetroPlusHealth (New York, NY)
- …to Health Edge / Health Rules Payer (HRP) core system for Provider Network Operations (PNO). This role will be part of cross functional and multi-departmental work ... to a new core claim system (Health Rules Payer or HRP) for Provider Network Operations team (PNO) Attend all needed HRP meetings through a phased roll out by product… more
- FM (Reston, VA)
- …and make a difference in the future - yours, your clients', and the company's? The Claims team within our DC Operations in Reston (VA) has a great opportunity ... solutions. FM helps clients maintain continuity in their business operations by drawing upon state-of-the-art loss-prevention engineering and research;...summer 2026! When you join FM as a Property Claims intern, you can bring your talents to life… more
- Eisai, Inc (Nutley, NJ)
- …is your profile, we want to hear from you. The Associate Director, Compliance Operations will be a key member of Eisai's US Ethics & Compliance team, responsible ... identify potential compliance risks or violations Partner with Commercial Operations , IT, and Finance to understand existing systems and...Drug, and Cosmetic Act - Anti-Kickback Statute - False Claims Act - OIG/DOJ Guidance - Federal and State… more
- FM (Norwood, MA)
- …and make a difference in the future - yours, your clients', and the company's? The Claims team within our Boston Operations has a great opportunity for you for ... solutions. FM helps clients maintain continuity in their business operations by drawing upon state-of-the-art loss-prevention engineering and research;...Summer 2026! When you join FM as a Property Claims intern, you can bring your talents to life… more
- Commonwealth Care Alliance (Boston, MA)
- …systems (eg, Salesforce) and provider relationship management tools. - Understanding of claims operations , utilization management, and quality programs as they ... medical management, and analytics teams to advance provider network operations , education, and performance improvement. The Provider Relations Director reports… more
- Sentry Insurance (Windsor, CT)
- …to and work in conjunction with the functional units of Loss Control, Claims and Operations to provide that service. Develop and maintain relationship/services, ... and works closely with management, Underwriting, Loss Control and Claims in determination of acceptability of the risk and...with insureds during safety inspections, and participating in mid-year claims review meetings Ability to travel and have a… more
- PRGX (Bentonville, AR)
- …the client's business operations . + Finds, supports, and documents audit and claims operations . + Produces claims using appropriate audit concepts for ... writing claims , updating claims management system, and billing claims to client. + Provides vendors with claim back-up information. May contact vendors for… more
- Lyric (Newtown Square, PA)
- …consult with and inform Lyric's clients. + Familiarity with affordability, claims operations , payment integrity, utilization management, medical policy and/or ... ambassador to payer clients, engaging directly with medical directors, clinical operations executives, and CMOs. + Build trusted advisory relationships that expand… more
- Commonwealth Care Alliance (Boston, MA)
- …and authorization process highly desired. + Experience with and understanding of Claims operations preferred. **Knowledge, Skills & Abilities (Required)** + ... with and visits to provider sites. Visits may include regular operations meetings, staff education, provider orientations, and appreciation events. + Facilitate… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …team, and disease management). + Collaborates, educates, and consults with Customer Service/ Claims Operations , Sales and Marketing and Health Care Services to ... Departments such as FEP, National Account Liaisons, Health Care Services and Claims to ensure appropriate cost-effective care by applying their clinical knowledge… more
- Jazz Pharmaceuticals (Palo Alto, CA)
- …leadership partners in Field Leadership, Marketing, Market Access, Business Operations , DEC (Digital Enterprise Capabilities) and the Learning and Development ... of a growing business. Deep experience with Oncology data sources (eg, Claims , EHR) preferred. Demonstrated ability to influence senior management and key business… more
- AC Pro (Fontana, CA)
- …and company policies across all properties. Partner with HR, Safety, and Operations on worker's compensation claims and return-to-work programs. Promote company ... and accurate order picking, staging, loading vehicles. Supervise night shift operations across multiple properties, including warehouse operations , fabrication… more
